ABSTRACT
INTRODUCTION: Bacillary angiomatosis (BA) is a rare, opportunistic infectious disease caused by the aerobic Gram-negative bacilli Bartonella henselae or Bartonella quintana. The main reservoir for those microbes are cats. The disease mostly affects immunocompromised patients with human immunodeficiency virus infection, after organ transplantation, undergoing corticosteroid and methotrexate therapy or with oncological history. CASE REPORT: We represent the case of a 65-year-old man who reported to the Department of Dermatology with a high fever and numerous nodular skin lesions on the 5th month of kidney transplantation. At that time, his immunosuppressive therapy consisted of tacrolimus 6 mg/day, mycophenolate mofetil 2 g/day, and prednisone 5 mg/day. Laboratory tests revealed an increased leukocyte count and elevated values of acute-phase proteins, but blood cultures were negative. Skin biopsy was performed and BA was diagnosed. The patient was given oral doxycycline 100 mg twice a day. During antibiotic therapy, his body temperature normalized and skin lesions began to resolve. The patient continued the above treatment for the next 3 months with good tolerance, and no relapse occurred in 1 year. CONCLUSION: BA should be listed among possible opportunistic infections in organ transplant recipients.
Subject(s)
Angiomatosis, Bacillary/microbiology , Immunosuppression Therapy/adverse effects , Kidney Transplantation/adverse effects , Opportunistic Infections/microbiology , Postoperative Complications/microbiology , Aged , Angiomatosis, Bacillary/chemically induced , Angiomatosis, Bacillary/drug therapy , Animals , Anti-Bacterial Agents/therapeutic use , Bartonella henselae , Cats , Doxycycline/therapeutic use , Humans , Immunocompromised Host , Male , Opportunistic Infections/chemically induced , Opportunistic Infections/complications , Opportunistic Infections/drug therapy , Postoperative Complications/chemically induced , Postoperative Complications/drug therapy , Skin/microbiologySubject(s)
Angiomatosis, Bacillary/chemically induced , Bartonella henselae/isolation & purification , Crohn Disease/drug therapy , Granuloma/microbiology , Liver Diseases/microbiology , Tumor Necrosis Factor Inhibitors/adverse effects , Adult , Angiomatosis, Bacillary/microbiology , Crohn Disease/microbiology , Female , Granuloma/diagnostic imaging , Granuloma/pathology , Humans , Liver Diseases/diagnostic imaging , Liver Diseases/pathology , Tomography, X-Ray ComputedSubject(s)
Angiomatosis, Bacillary/chemically induced , Antifungal Agents/adverse effects , Bartonella Infections/drug therapy , Cyclosporine/adverse effects , Polyps , Bartonella Infections/complications , Bone Marrow Transplantation , Female , Humans , Male , Polyps/chemically induced , Polyps/microbiology , Treatment OutcomeABSTRACT
Bacillary angiomatosis, a rare and possibly fatal disease, occurs mainly in HIV-infected patients. However, it has been reported in patients with cancer and in recipients of solid organs receiving immunosuppressive drugs such as cyclosporine. This case report describes a 66-year-old man who came to dermatology practice in Clarksburg for an initial visit. He had a longstanding history of psoriasis and psoriatric arthritis treated with methotrexate. A biopsy of a skin lesion on his neck confirmed the diagnosis of bacillary angiomatosis.
Subject(s)
Angiomatosis, Bacillary/chemically induced , Folic Acid Antagonists/adverse effects , Immunocompromised Host , Methotrexate/adverse effects , Aged , Angiomatosis, Bacillary/diagnosis , Angiomatosis, Bacillary/drug therapy , Arthritis, Psoriatic/drug therapy , Diagnosis, Differential , Disease Susceptibility/chemically induced , Doxycycline/therapeutic use , Humans , Male , Time FactorsABSTRACT
Bacillary angiomatosis is an infectious disease of the skin and viscera characterized by vascular lesions, originally described in patients with human immunodeficiency virus infection. There are also case reports of bacillary angiomatosis occurring in immunocompetent patients and in noninfected patients with suppressed immune function. We report a case of bacillary angiomatosis in a child undergoing chemotherapy for acute leukemia.
